Field Assessment
by TheShadowArchitect
Summary: Natasha was shot during the fight with the Winter Soldier. Rescued by Hill, it is now up to Sam to make sure she's alive to continue their mission. Missing scene from CATWS.


I don't think people give Sam Wilson enough credit for being a PJ, but I wanted to give him a little love. So here goes.

Missing scene from CA:TWS

TW: depictions of blood, injury

Also this is the first fanfiction I've published on here in ages, and the first thing I've done in present tense, so constructive criticism is welcome

FIELD ASSESSMENT

Natasha goes first, followed by Sam. The van's going a little over thirty-five. Asphalt for landing. Fourteen inches of clear space between the undercarriage and the road. Its not a lot of space to roll out of a fall. Factor in the stress, the width of the van, the width of the hole in the undercarriage and the gunshot wound and there's not a lot of room for error.

Still, Hill has risked a lot for this. Not to mention the certain death that awaits them if they don't somehow escape the van. So there also isn't a lot of choice.  
>The plan is simple. Drop and roll sideways. At thirty-five miles an hour, the van should clear them before getting trapped under the rear tires is a possibility. At least, that's the hope.<p>

Natasha looks at the rushing asphalt fewer than two feet below her, takes a breath, and jumps. She knows there will be pain, and blocks it out before it hits her. The full maneuver takes fewer than two seconds. Drop, impact, and roll left off the road. It happens incredibly fast. The impact is the worst part. She can feel the heat of the friction against her jacket for an instant, scoring deep into the leather. Her body is tense, though, and already in pain. If the road rash scores into her flesh as well, she doesn't feel it. Once she finds herself in a ditch on the side of the road, out of sight of the other vans, she lays still.

Sam rolls out of the landing with practiced ease. It has been a while since he's had to drill a landing, but muscle memory picks up the slack. A quick self-assessment reveals that his clothing is torn up, but the only injury is a stretch of road rash on his upper arm and thigh. Both wounds are bleeding but they're superficial. He budgeted for worse.

He waits for the other vans to pass, then gets up. He doesn't see Natasha immediately. The road stretches along a heavily forested hill, dropping off to an embankment, and then a further two or three story drop to a river below. There is a lot of undergrowth. Trees line the embankment, and the fall below it. He determines that it is unlikely Natasha fell the entire way to the river. That would leave her easier to find, but possibly in worse shape.

He stays low. By his calculation, Natasha is about fifty yards behind where he landed. He moves quickly, keeping below the line of sight afforded by the road. His injuries, though minor, look bad at first glance. Anyone else who comes along this road might be tempted to stop and help. He knows he has no excuse and their presence would complicate things immensely.

He sees her about twenty feet out. "Natasha, its Sam." He says, announcing himself. His voice is just loud enough to carry to her and not much further. No one else seems to be here, but with everything that's happened, he figures better safe than sorry.

She's lying still, and he can't tell if she's conscious or not. At ten feet he determines that she is breathing.

He kneels between her and the second drop. Breathing implies circulation. With no other assessment her most pressing injury is still the gunshot wound in her left shoulder.

"Nat, you with me?" He asks.

"Mmm-hmm." She responds quickly. She opens her eyes. They seem clear, but he can tell she's in pain. She also hasn't voluntarily moved. His hands go to his chest and what should have been packs of compression bandage, hemostatic agent and sublingual fentanyl. They're not there and he all but rolls his eyes at himself. Muscle memory again. He feels for a pulse and counts respirations.

"Tell me your name, what happened and where you are." He orders anyway. She grumbles at this, but obliges. He assumes she's been in this situation a time or two before and skips the pleasantries.

"Natasha Romanoff, Hydra are assholes and I jumped out of a moving van, the side of the road."

"Thanks."

She shrugs with her good shoulder, telling him she understands which one is injured. That's a good thing.

"I'm trained to do an assessment, I'll walk you through it as I go." He announces. "I'm also going to ask some questions. Say yes or no, don't move."

"Yes." She smiles.

"Clever." He responds, deadpan. "Are you hurting anywhere that isn't your left shoulder?" He asks. She thinks for a moment.

"Right hip but its not bad." She answers. He looks. It's road rash, her jeans are shredded in spots and she's bleeding, but its not deep. It looks painful but he's surprised she can feel it over the GSW and adrenalin. He tells her as much.

"I'm going to look at the wound in your shoulder. Might hurt a little bit, but hold on." For a second time his hands go to his chest. He still doesn't have the medical supplies, but he needs to see how bad it is anyway. The way she was drifting in the van suggests that her blood pressure has dropped significantly, either due to blood loss or shock from pain. The improvement now that she is laying flat points to the former. Good sign provided he can _stop_ the bleeding before she slips into shock from it.

He eases her jacket open. Years in pararescue mean he's seen a lot of blood. The wound looks like it's gone all the way through. Her skin is dark red with congealing blood and her black undershirt glistens, soaked. He finds himself fighting with muscle memory now, his hands telling him to grab trauma shears, cut off the jacket and shirt, apply a pressure bandage. He overrides these commands. Though there is a lot of blood there, the bleeding has slowed and he doesn't have the supplies.

He surveys her hands quickly. Both are normally colored. If the bullet has grazed her subclavian artery she'd have already bled out, and if it'd severed it, her left hand would be starkly white or blue. Neither is the case.

He doesn't tell her she is lucky. From his experience the phrase serves no purpose and leads to a false sense of security. She's still on shaky ground and they both know it.

He feels her head for deformity, open skin, tenderness, swelling. Does the same for her throat and neck, pushes his hands underneath her and checks her spine all the way down to her hips. It takes him seconds. "Anything hurt?" he asks.

"No."

"Okay, this will." He turns her on her side away from him to survey the exit wound. He hears her hiss in pain as he pulls the jacket off her arm and upper back gently but as quickly as he can. The bleeding is worse here. The lining of her jacket is thick with it, the back of her undershirt almost entirely soaked, as well as the waist of her jeans. The bullet has travelled almost sideways, through the flesh of her inner shoulder, grazing the ball of her humerus and exiting the back of her deltoid. The wound is jagged, unlike the neater hole in the front. Blood is still oozing from it, cutting a fresh trail through the congealing blood on her back. He rips a strip from the bottom of his shirt and folds it into a thick square large enough to cover the exit wound. "Ready?" He asks.

She nods. He presses the square against the exit wound, and then rolls her back. It will put at least some pressure on it, and hopefully slow the loss of blood until he can get real supplies. Her face is white and her breathing is shallow and faster than before. He feels for a pulse again, this time as comparison. The rate is similar, but her pressure has definitely dropped. Warning bells go off in his head about insufficient cardiac output, but he keeps his face neutral.

"Nat, what's going on right now, what do I need to know?" He asks. He wants her to tell him something hurts, something he missed, something he can see to.

"Steve and Hill are here." She says instead. Even better. She's weak, but she's still with him, she's still conscious, and she's still more aware than he is about what's going on. Steve runs over first. Sam tells him to press on the entry wound. He does so without question, pushing hard on her shoulder. She gasps, but Sam is thankful this is not Steve's first rodeo. With that being taken care of, he goes on to finally finish his assessment.

"Sam, report."

"She weathered the exit with only some road rash, primary concern is blood loss from GSW in her left shoulder." He started. He should have shortened it to that, but his mind was generating an SBAR report and he didn't stop it. "She seems to be in otherwise good physical health. Assessment finds that she is A&O times 4, pulse and respers are high and shallow and pressure is presumed low due to blood loss. Recommend immediate evac to medical care." Hill looks impressed at this.

"Can do." She says, nodding. "There's an unmarked van not too far from here, I'll go and get it, bring it around. Shouldn't be too long before they realize we're gone but I want to be out of here well before that. There're medical supplies in the van." She said. "Give me ten minutes." Sam nods, thanking her silently. Now that Natasha is flat again, she seems to be doing better, but she'll need fluid replacement and probably blood to bring her pressure up and prevent shock. He doubts the van will have that, but even a compression bandage would be helpful.

Hill is back with the van quickly. Sam and Steve help Natasha to it. She seems weak, but refuses to be carried. Even so, she allows them to bare most of her weight as they climb the embankment back to the road and into Hill's van. When she sits down, she wavers for a moment. Sam catches her and begins to lower across the seats.

"I'm good." She says, trying to stop her decent.

"It's okay." Sam starts. "Let us worry about that." But she is adamant.

"I'm good." She says again, and with what looks like great effort, pushes herself back up to sitting. Her head falls back over the seat and she's putting effort into breathing more slowly and deeply. Sam nods, placing himself next to her on the seat in case she falls. Steve hands him a bandage. Its about the most beautiful thing he's ever seen.

"I'm going to move your arm, its going to hurt. If you feel like you're going to faint, say something, okay?" He keeps her body angled toward him. If she falls, he'll be able to catch her more easily that way. Finally with access to trauma shears, he cuts through her undershirt and presses the pad against the bloodsoaked and wadded shirt. In the front, he places an ABD pad, and then wraps the compression part of the bandage around her arm, shoulder and chest.

He notices she's shivering now. He wraps her jacket back around her, knowing that its not perfect, but better than nothing.

Once Natasha is safe, it occurs to him that he doesn't know where they're going. He asks Steve, who shrugs.

Natasha is leaning against him. Her face is taut and her eyes only vaguely open. She needs IV fluids and blood, but seems to be stable enough for now without them. He's glad. Not everyone would be. Still, he keeps her talking.

"You have any allergies?" He asks. She looks at him grumpily. He knows she's fighting sleep.

"No." She says.

"On any medications?"

"No."

"When was the last time you ate or drank anything?" She looks up from his shoulder just long enough to glare at him pointedly. He shrugs. He supposes that he knows that anyway and lets it go.

"Anything else I should know?"

"No."

He takes her vitals and they talk about other stuff then. Or rather he does. Steve seems to be pretty deep in thought and doesn't join in. Natasha really only joins in reluctantly, when he prompts her to, to make sure she's still conscious. He talks about Riley, a couple of missions they ran together one time. Then that kind of conversation doesn't seem so pertinent.

They drive for about an hour. When the van finally crunches to a stop, Steve is the first one up, putting his body protectively between Sam and Natasha and the door. He doesn't need to. Hill is standing there. Steve helps Natasha down and Hill leads them all into the bunker.

There, Sam watches as Natasha receives care. Fluids and blood and x-rays and painkillers and strong antibiotics. A doctor injects local anesthetic and cauterizes the vessels that are still bleeding. He determines that the damage isn't bad, and stitches the wound. On top of that goes skin glue and steri-strips. The procedure is rough and dirty and from the look on Natasha's face she's been under medicated for it.

Sam is disappointed and frankly angry about it until he realizes one thing. The treatment isn't so she can spend the rest of the week in bed recovering. Its so she can get back out in the field. Its not until then that he starts to see it. Injuries be damned, they have a lot of work left to do before the day is over.


End file.
